Folate Receptor Antibody Test (FRAT Test) with Online Physician Consultation
$594.00
Order the FRAT Folate Receptor Antibody Test with physician consultation and report review. The $594 package includes the $295 test kit plus $299 doctor review, with leucovorin/folinic acid prescribed when clinically appropriate.
Description
Folate Receptor Antibody Test Cost, Process, and What’s Included
The FRAT® test checks for blocking and binding antibodies to the folate receptor-alpha. These antibodies may interfere with folate transport into the brain and are often considered in autism, developmental delay, language delay, and suspected cerebral folate deficiency.
This package includes the FRAT® test kit, lab processing, physician consultation, questionnaire review, and a written report from David Epstein, D.O.
```What You Get
```FRAT® Test Kit and Lab Processing
The FRATNow collection kit is shipped to you. Blood is drawn locally by a phlebotomist, nurse, or approved draw site, following the FRATNow collection and shipping instructions.
Comprehensive Questionnaire
The questionnaire reviews autism-related concerns, developmental history, language and social communication, folate sensitivity, nutrient concerns, gut/immune patterns, and methylation-related traits.
Physician Interpretation and Report
David Epstein, D.O. reviews the FRAT® result, questionnaire, and relevant history, then provides a written report with practical next steps.
Leucovorin When Appropriate
When the FRAT® test is positive and the clinical history supports treatment, leucovorin / folinic acid may be prescribed.
Why the Questionnaire Matters
The FRAT® result is important, but it is only one part of the decision. The questionnaire helps place the test result into a broader clinical context.
```If FRAT® Is Positive
The report helps determine whether leucovorin / folinic acid is clinically appropriate, what concerns should be considered, and what follow-up may be needed.
If FRAT® Is Negative
A negative test can still be useful. The updated questionnaire can help identify other nutrient, methylation, gut, immune, inflammatory, or functional health patterns that may deserve follow-up.
How FRAT® Testing Works
```Order the FRAT® Test Package
Order the package on this page. The $594 total includes the test kit, physician consultation, and written report.
Receive the Requisition and Test Kit
The requisition is emailed by Second Opinion Physician. The FRATNow test kit is shipped to you.
Complete the Blood Draw
Have the blood sample drawn locally by a phlebotomist, nurse, or approved draw site. Follow FRATNow collection and shipping instructions.
Complete the Questionnaire
The questionnaire reviews symptoms, history, folate sensitivity, nutrient concerns, gut/immune factors, and methylation-related patterns.
Physician Review and Written Report
David Epstein, D.O. reviews the results and questionnaire, then provides a written report with interpretation and next steps.
Consultation and Treatment Discussion
The consultation reviews treatment options, including whether leucovorin / folinic acid may be appropriate.
Who Should Consider FRAT® Testing?
Autism and Development
- Autism spectrum concerns
- Language delay or regression
- Social communication concerns
- Developmental delay
Folate Transport Concerns
- Suspected cerebral folate deficiency
- Prior concern for folate receptor antibodies
- Interest in leucovorin / folinic acid treatment when clinically appropriate
- Neurologic or behavioral symptoms where folate transport problems are being considered
When FRAT® Is Positive vs. Negative
```If FRAT® Is Positive
The main concern is impaired folate transport related to folate receptor antibodies. In this setting, leucovorin / folinic acid may help bypass the folate transport issue.
Your report explains the result, clinical significance, treatment considerations, and follow-up recommendations.
If FRAT® Is Negative
A negative result may suggest that folate receptor antibodies are not the main driver, but symptoms may still involve other biochemical or functional patterns.
- Undermethylation or high histamine patterns
- Low SAM or elevated SAH
- Zinc deficiency or copper imbalance
- Gut and immune burden
- Inflammation, glutathione demand, or mitochondrial stress
What Is Included in the $594 Package?
- FRAT® test kit and lab processing: $295
- Physician consultation and written report: $299
- Symptom and history questionnaire review
- FRAT® result interpretation
- Discussion of leucovorin / folinic acid when clinically appropriate
- Next-step recommendations when FRAT® is negative or incomplete
- Guidance on whether broader methylation or nutrient testing may be useful
Why Physician Review Matters
Many patients and parents search for the FRAT test cost because they want the lab test itself. The lab result is important, but it is only part of the decision.
A positive FRAT® result may raise the question of leucovorin treatment. A negative result may shift attention toward methylation, nutrient status, gut/immune factors, inflammation, or other contributors.
The physician review helps connect the test result to the patient’s actual symptoms, history, and next steps.
Order the FRAT® Test Kit + Physician Consultation
The $594 package includes the FRAT® test kit, laboratory processing, questionnaire review, physician consultation, and written report.
Leucovorin / folinic acid may be prescribed when clinically appropriate.
Order FRAT® Test PackageFOLATE RECEPTOR ANTIBODY TEST (FRAT®)
WHAT IS FRAT (Folate Receptor Autoantibodies Test) is a specialized blood test developed by Dr. Edward Quadros at SUNY Downstate Medical Center. It is the only assay that detects both blocking and binding autoantibodies to the folate receptor alpha (FRα). These antibodies can interfere with the transport of folate (vitamin B9) into the brain and central nervous system, leading to serious neurological and psychiatric effects.
FRAT® has been validated in clinical research and is published in top-tier journals including the New England Journal of Medicine. It has been used in numerous clinical trials and is considered the gold standard for identifying cerebral folate deficiency due to autoimmunity.
WHO SHOULD CONSIDER THIS TEST? You may be a candidate for FRAT® testing if you or your child experience any of the following conditions:
- Autism Spectrum Disorder (ASD), particularly with language delay
- Cerebral Folate Deficiency Syndrome (CFDS)
- Treatment-resistant Depression
- Schizophrenia or psychotic spectrum disorders
- Developmental Delay
- Neurological regression without clear cause
- Chronic fatigue or cognitive decline
Testing is especially important in children, as early identification of folate receptor autoantibodies can improve the outcome of treatment and prevent further developmental or neurological decline.
WHY THIS TEST MATTERS The presence of folate receptor autoantibodies can significantly impair the ability of folate to reach the brain via the choroid plexus and cerebrospinal fluid. This can result in symptoms related to mood, cognition, speech, and behavior. When identified, treatment with high-dose folinic acid (leucovorin calcium) may bypass this blockage and restore brain folate levels.
Clinical Evidence: One landmark study by Frye et al. (Molecular Psychiatry, 2016) found that children with autism and language impairment who were positive for folate receptor autoantibodies showed significantly improved verbal communication after 12 weeks of high-dose folinic acid therapy. Those who were FRAA-positive had even greater benefit, with a large effect size (Cohen's d = 0.91).
Note: This test is not available without physician authorization. Your report and recommendations will be reviewed directly by a licensed physician.